Outcomes of static and dynamic facial nerve repair in head and neck cancer.

Autor: Iseli TA; Department of Otolaryngology, Head & Neck Surgery, Royal Melbourne Hospital, Parkville, Victoria, Australia., Harris G, Dean NR, Iseli CE, Rosenthal EL
Jazyk: angličtina
Zdroj: The Laryngoscope [Laryngoscope] 2010 Mar; Vol. 120 (3), pp. 478-83.
DOI: 10.1002/lary.20789
Abstrakt: Objectives/hypothesis: Determine outcomes associated with nerve grafting versus static repair following facial nerve resection.
Study Design: Retrospective chart review.
Methods: Charts from 105 patients who underwent facial nerve reconstruction between January 1999 and January 2009 were reviewed. The majority had parotid malignancy (78.1%), most commonly squamous cell carcinoma (50.5%). Patients underwent static (n = 72) or dynamic (n = 33) reconstruction with nerve grafting. Facial nerve function was measured using the House-Brackmann (H-B) scale.
Results: Patients receiving static reconstruction were on average 10.3 years older (P = .002). Mean overall survival for tumor cases was 61.9 months; parotid squamous cell carcinoma was associated with worse prognosis (P = .10). Median follow-up was 16.1 months (range, 4-96.1 months). Most (97%) patients receiving a nerve graft had some return of function at a median of 6.2 months postoperatively (range, 4-9 months) and the majority (63.6%) had good function (H-B score Conclusions: Where possible, nerve grafting is the preferred method of facial nerve reconstruction. Although elderly patients with parotid malignancy have traditionally been considered poor candidates for nerve grafting, we demonstrate good results within 9 months of facial nerve repair even with radiotherapy, the use of long grafts (>6 cm), and prolonged preoperative dysfunction.
Databáze: MEDLINE
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